Healthcare-Associated Infections in Acute Ischaemic Stroke Patients from 36 Japanese Hospitals: Risk-Adjusted Economic and Clinical Outcomes
| Autor: | Tetsuya Otsubo, Miho Sekimoto, Yuichi Imanaka, Hiroshi Ikai, Jason Lee |
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| Rok vydání: | 2011 |
| Předmět: |
Male
medicine.medical_specialty Databases Factual Iatrogenic Disease MEDLINE Logistic regression Brain Ischemia Japan Economic cost Ischaemic stroke medicine Humans Coma Intensive care medicine Aged Cross Infection Health economics business.industry Incidence (epidemiology) Odds ratio Middle Aged Confidence interval Stroke Treatment Outcome Neurology Emergency medicine Female Risk Adjustment business |
| Zdroj: | International Journal of Stroke. 6:16-24 |
| ISSN: | 1747-4949 1747-4930 |
| DOI: | 10.1111/j.1747-4949.2010.00536.x |
| Popis: | Background Healthcare-associated infections are a major cause for worsening in ischaemic stroke patients. In addition to increased morbidity and mortality, healthcare-associated infections also result in a potentially preventable increase in economic costs. Aims The aim of this study was to identify healthcare-associated infection incidence in ischaemic stroke patients in Japanese hospitals, and to conduct a risk-adjusted analysis of the associated economic and clinical outcomes. Methods Healthcare-associated infections were identified in 36 Japanese hospitals using an administrative database. Identification was carried out using a combination of International Classification of Diseases-10 codes and antibiotic utilisation patterns that indicated the presence of an infection. Risk-adjusted hospital charges and length of stay were calculated using multiple linear regression analyses correcting for patient and hospital factors. A logistic regression model was used to analyse the association between healthcare-associated infection infection and mortality. Results There was an overall healthcare-associated infection incidence of 16·4 %, with an interhospital range of 4·7–28·3%. After risk-adjustment, infected cases paid an additional US$3 067 per admission (interhospital range US$434–US$7 151) and were hospitalised for an additional 16·3-days (interhospital range: 5·1–25·1-days) when compared with uninfected patients. Healthcare-associated infections also had a strongly significant association with increased mortality (odds ratio=23·2, 95% confidence intervals: 12·5–43·2). Conclusions We observed a wide range of healthcare-associated infection incidence between the hospitals. Healthcare-associated infections were found to be significantly associated with increased hospital charges, length of stay, and mortality. Furthermore, the use of risk-adjusted multi-institutional comparisons allowed us to analyse individual performance levels in both infection and cost control. |
| Databáze: | OpenAIRE |
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